1. Using Public Health Data to Assess Vulnerability and Cumulative Impacts to Health Jerald A. Fagliano, M.P.H., Ph.D. Environmental and Occupational Health Surveillance Program New Jersey Department of Health and Senior Services April 13, 2011 Clean Air Council

2. Outline What public health data sets are available? Data resources: –Environmental Public Health Tracking –http://nj.gov/health/ephthttp://nj.gov/health/epht –NJ State Health Assessment Data (NJ SHAD) –http://nj.gov/health/shadhttp://nj.gov/health/shad Using public health data to assess cumulative impacts

3. Key Data Sets Relevant to Environmental Public Health Vital Events –Births –Deaths –Infant and fetal deaths Health Outcome Registries –Cancers –Birth defects Administrative Data –In-patient hospitalization and emergency department Laboratory Reports on Exposure –Childhood blood lead

4. EPHT and NJ SHAD State Health Assessment Data (NJ SHAD) system, a public health data resource –Includes custom data query, public health indicators, and links to reports NJ Environmental Public Health Tracking program supports and uses NJ SHAD as its data portal –Part of national EPHT Network with CDC, 25 States, and New York City

7. Health Disparity Priority Areas: Asthma Cancer Heart Disease Kidney Disease Diabetes HIV/AIDS Immunization Infant Mortality Obesity Injuries Violence

8. Environmental Public Health Tracking: Air Quality Drinking Water Lead Exposure Birth Outcomes Infant Outcomes Cancers CO Poisoning Asthma Heart Attack Occup. Injuries

9. Age-Adjusted Death Rate due to Heart Disease, NJ and US, 2000-2006

10. Age-Adjusted Death Rate due to Heart Disease, by Race/Ethnicity, 2006

11. Percent of Live Births with Low Birth Weight, 2001-2005 Percent of Children Under Age 5 Years of Age Living in Poverty, 2000

13. Percent of Infants with Low Birth Weight, by Mother’s Education and Prenatal Care, 2000-2007

14. Diseases of the heart Malignant neoplasmsCerebrovascular diseases All causes of death Age-Adjusted Death Rates by Race/Ethnicity, State of NJ, 2000-2006

15. Age-Adjusted Death Rate due to Cancers, by County and Race/Ethnicity, 2004-2006

16. Planned Improvements to NJ SHAD Dynamic mapping of query output Additional data sets: –Hospitalization and emergency department –Childhood lead exposure –Cancer Secure portal for access to data at finer geographic and temporal scales

17. Public Health Measures as Cumulative Impact Measures Public health measures are measures of “cumulative impact” from: –Heritable risk factors –Personal behaviors –Community/social stressors –Environmental and occupational exposures Challenge is in understanding how these factors interact to produce health impacts May indicate degree of potential vulnerability to added environmental stressors

18. Health Outcome Indicators of Vulnerability to Environmental Impact General measures of health –Mortality (age-adjusted rates) Overall, cardiovascular, cancer –Infant and fetal mortality –Low birth weight among singleton, term births More specific measures –Childhood lead exposure –Hospitalization and emergency department use due to asthma or heart attack –Cancer incidence Leukemia, lymphoma, bladder, lung –Birth defects Clefts, neural tube defects, heart anomalies

19. For more information: Environmental Public Health Tracking –http://nj.gov/health/ephthttp://nj.gov/health/epht –http://ephtracking.cdc.govhttp://ephtracking.cdc.gov NJ State Health Assessment Data –http://nj.gov/health/shadhttp://nj.gov/health/shad Strategic Plan to Eliminate Health Disparities in New Jersey –http://nj.gov/health/omh/planhttp://nj.gov/health/omh/plan